Abstract:
:Although recent evidence indicates that the quasispecies nature of HCV constitutes a critical strategy for the virus to survive in the host, the mechanisms of viral persistence remain unknown. Similarly, the correlates of immune protection in a limited proportion of individuals who succeed in clearing HCV are still largely undefined. Understanding the mechanisms of sterilizing immunity is essential for devising preventive measures against HCV and unraveling how the virus eludes such immunity. As in other viral infections, the complex interactions between the virus and the host early in the course of HCV infection probably determine the outcome of the disease (i.e., resolution or persistence). The evidence now accumulated on HCV and other models of viral infection is compatible with the hypothesis that both cellular and humoral components are needed for definitive viral clearance. Nevertheless, detailed studies of the specific cellular and humoral immune responses during the incubation period and the acute phase of hepatitis C, in relation to the viral quasispecies evolution and the clinical outcome, are still lacking both in humans and in the chimpanzee model. Until such studies are performed, most ideas of viral clearance mechanisms remain hypothetical, and the immunologic basis of HCV clearance will continue to be inferred from associations rather than from causal relationships.
journal_name
Clin Liver Disjournal_title
Clinics in liver diseaseauthors
Farci Pdoi
10.1016/s1089-3261(05)70200-2subject
Has Abstractpub_date
2001-11-01 00:00:00pages
895-916issue
4eissn
1089-3261issn
1557-8224pii
S1089-3261(05)70200-2journal_volume
5pub_type
杂志文章,评审abstract::Combination therapy with beta-blockers and endoscopic band ligation (EBL) is the standard prophylaxis of esophageal variceal rebleeding in cirrhosis. Beta-blockers are the backbone of combination therapy, since their benefit extend to other complications of portal hypertension. EBL carries the risk of post-banding ulc...
journal_title:Clinics in liver disease
pub_type: 杂志文章,评审
doi:10.1016/j.cld.2014.01.007
更新日期:2014-05-01 00:00:00
abstract::Decision analysis helps evaluate competing strategies under conditions of uncertainty in a wide variety of clinical settings. Despite some limitations, decision trees and Markov models remain essential tools for medical decision analysts. These techniques allow comparison of competing management strategies in a quanti...
journal_title:Clinics in liver disease
pub_type: 杂志文章,评审
doi:10.1016/j.cld.2004.12.004
更新日期:2005-05-01 00:00:00
abstract::Liver cancer is the second leading cause of global cancer mortality. The major risk factors for hepatocellular carcinoma (HCC) are being addressed with success by prevention efforts. Vaccination against hepatitis B virus has reduced incidence of HCC in Taiwan and is partly responsible for lower rates in China. New inf...
journal_title:Clinics in liver disease
pub_type: 杂志文章,评审
doi:10.1016/j.cld.2015.01.001
更新日期:2015-05-01 00:00:00
abstract::The Model for End-stage Liver Disease (MELD) has been demonstrated to be an excellent predictor of survival in patients who have end-stage liver disease. It is derived from the international normalized ratio (INR) of prothrombin time, serum creatinine, and serum total bilirubin. The major use of the MELD score is to p...
journal_title:Clinics in liver disease
pub_type: 杂志文章
doi:10.1016/j.cld.2008.09.001
更新日期:2009-02-01 00:00:00
abstract::AMA are detected in the serum of 92% to 95% of patients with PBC using indirect immunofluorescent methods. AIC is the term used to describe the 5% to 8% of AMA-negative PBC patients who uniformly have ANA and SMA. Recent applications of more sensitive and specific tests to detect serum AMA have shown that most, if not...
journal_title:Clinics in liver disease
pub_type: 杂志文章,评审
doi:10.1016/S1089-3261(03)00132-6
更新日期:2004-02-01 00:00:00
abstract::Hepatic granulomas are a common finding in systemic sarcoidosis, but most patients remain asymptomatic. Elevated alkaline phosphatase is the most common sign of hepatic sarcoidosis (HS). Lacking a specific diagnostic test, the diagnosis of HS is one of exclusion. Therapy may be indicated in a minority of patients to c...
journal_title:Clinics in liver disease
pub_type: 杂志文章,评审
doi:10.1016/j.cld.2018.12.012
更新日期:2019-05-01 00:00:00
abstract::The dual blood supply of the liver, originating from the portal vein and the hepatic artery, makes it relatively resistant to minor circulatory disturbances. However, hepatic manifestations of common cardiovascular disorders are frequently encountered in both the inpatient and outpatient setting. Beginning with the ma...
journal_title:Clinics in liver disease
pub_type: 杂志文章,评审
doi:10.1016/j.cld.2010.09.010
更新日期:2011-02-01 00:00:00
abstract::Imaging and imaging guided intervention have revolutionized the management of hepatic inflammatory diseases. Pyogenic abscess is preferentially treated percutaneously. Radiologic techniques are crucial for the diagnosis of amebic liver abscess and infectious conditions of the liver in immunocompromised patients. ...
journal_title:Clinics in liver disease
pub_type: 杂志文章,评审
doi:10.1016/s1089-3261(03)00073-4
更新日期:2002-02-01 00:00:00
abstract::Drug-induced liver injury (DILI) can be predictable or idiosyncratic and has an estimated incidence of approximately 20 cases per 100,000 persons per year. DILI is a common cause of acute liver failure in the United States. No accurate tests for diagnosing DILI exist, and its diagnosis is based on exclusion of other c...
journal_title:Clinics in liver disease
pub_type: 杂志文章,评审
doi:10.1016/j.cld.2016.08.012
更新日期:2017-02-01 00:00:00
abstract::A human betaretrovirus has been characterized in patients with primary biliary cirrhosis (PBC) and the related mouse mammary tumor virus linked with autoimmune biliary disease in the NOD.c3c4 mouse model. Translational studies have been performed in patients who have PBC to investigate the role of viral infection in d...
journal_title:Clinics in liver disease
pub_type: 杂志文章,评审
doi:10.1016/j.cld.2008.02.006
更新日期:2008-05-01 00:00:00
abstract::Non-alcoholic fatty liver disease (NAFLD) is common and may progress to end-stage liver disease. Liver-related morbidity and mortality occur almost exclusively in patients whose disease progresses to advanced fibrosis and cirrhosis. Presence and severity of liver fibrosis seem the most important indicators of long-ter...
journal_title:Clinics in liver disease
pub_type: 杂志文章,评审
doi:10.1016/j.cld.2007.02.004
更新日期:2007-02-01 00:00:00
abstract::Nonalcoholic fatty liver disease (NAFLD) is a common liver disorder that can be divided into benign steatosis or nonalcoholic fatty liver (NAFL) and nonalcoholic steatohepatitis (NASH). Elastography and scoring systems based on clinical features and routine biochemical testing can be used to assess fibrosis in patient...
journal_title:Clinics in liver disease
pub_type: 杂志文章,评审
doi:10.1016/j.cld.2017.08.006
更新日期:2018-02-01 00:00:00
abstract::A variety of benign and malignant neoplasms can be encountered in the liver. Hematoxylin and eosin-stained tissue sections alone may not yield sufficient information to definitively diagnose liver tumors; therefore, ancillary studies with immunohistochemical markers can play a crucial role in differentiating the diffe...
journal_title:Clinics in liver disease
pub_type: 杂志文章,评审
doi:10.1016/j.cld.2010.10.001
更新日期:2010-11-01 00:00:00
abstract::Osteopenia, in the form of osteoporosis, is a common complication of chronic cholestatic liver diseases and, although its cause is poorly understood, it appears to be intimately related to the cholestasis itself. With more patients surviving longer with successful liver transplantation, the clinical significance of su...
journal_title:Clinics in liver disease
pub_type: 杂志文章,评审
doi:10.1016/s1089-3261(05)70015-5
更新日期:1998-05-01 00:00:00
abstract::Noncirrhotic portal hypertension represents a heterogeneous group of conditions that have distinct clinical and hemodynamic features that often help distinguish them from cirrhosis. [figure: see text] The sites of portal flow resistance may not be precisely localized to one area of the hepatic lobule and may extend be...
journal_title:Clinics in liver disease
pub_type: 杂志文章,评审
doi:10.1016/s1089-3261(05)70191-4
更新日期:2001-08-01 00:00:00
abstract::Patients with sickle cell disease can develop liver disease as a result of intrahepatic sickling of erythrocytes, viral hepatitis and iron overload secondary to multiple blood transfusions, and gallstone disease as a result of chronic hemolysis. The spectrum of clinical liver disease is wide and often multifactorial. ...
journal_title:Clinics in liver disease
pub_type: 杂志文章,评审
doi:10.1016/j.cld.2018.12.002
更新日期:2019-05-01 00:00:00
abstract::The management of autoimmune and cholestatic liver disorders is a challenging area of hepatology. Autoimmune and cholestatic liver diseases represent a comparatively small proportion of hepatobiliary disorders, yet their appropriate management is of critical importance for patient survival. In this article, management...
journal_title:Clinics in liver disease
pub_type: 杂志文章
doi:10.1016/j.cld.2009.02.011
更新日期:2009-05-01 00:00:00
abstract::The management of patients who have portal hypertension has changed dramatically over the last 2 decades. Pharmacologic therapy benefits the patient by reducing the risk for an initial bleed, improving the management of an acute bleed, and in reducing the risk for a rebleed. Endoscopic management has improved progress...
journal_title:Clinics in liver disease
pub_type: 杂志文章,评审
doi:10.1016/j.cld.2006.08.020
更新日期:2006-08-01 00:00:00
abstract::Development of ethanol-induced fatty liver, alcoholic hepatitis, and cirrhosis has been attributed in part to nutritional deficiencies for many years. Special attention must be focused on treating alcohol-induced liver disease while providing replacement of deficient amino acids, vitamins, minerals, and other nutrient...
journal_title:Clinics in liver disease
pub_type: 杂志文章,评审
doi:10.1016/j.cld.2004.11.003
更新日期:2005-02-01 00:00:00
abstract::Primary biliary cirrhosis and primary sclerosing cholangitis share some clinical features with autoimmune hepatitis, but when features of autoimmune hepatitis are present, prognosis can be affected and immunosuppressive treatment warranted. The presence of severe interface hepatitis in primary biliary cirrhosis porten...
journal_title:Clinics in liver disease
pub_type: 杂志文章,评审
doi:10.1016/j.cld.2012.12.006
更新日期:2013-05-01 00:00:00
abstract::Bile acid synthetic defects are uncommon disorders that cause progressive cholestatic liver disease that is often lethal in infancy or early childhood. Five specific primary defects have been described. Diagnosis is based on mass spectrometry of urine and serum. Pathogenesis of liver injury is related to persistent re...
journal_title:Clinics in liver disease
pub_type: 杂志文章,评审
doi:10.1016/s1089-3261(05)70144-6
更新日期:2000-11-01 00:00:00
abstract::Pharmacologic management of hepatic encephalopathy includes a broad range of therapies. This article covers the specific mainstays of therapies, such as antimicrobials and laxatives, with an established evidence base. This article also covers newer modalities of therapies, such as fecal microbiota transplant, probioti...
journal_title:Clinics in liver disease
pub_type: 杂志文章,评审
doi:10.1016/j.cld.2020.01.005
更新日期:2020-05-01 00:00:00
abstract::Primary sclerosing cholangitis is characterized by progressive fibrosing obliteration of the biliary tract. In some cases the disease is restricted to the small bile ducts, but most patients develop fibrotic stenoses of the larger bile ducts. Despite advances in magnetic resonance cholangiography, in unclear cases end...
journal_title:Clinics in liver disease
pub_type: 杂志文章,评审
doi:10.1016/j.cld.2010.03.010
更新日期:2010-05-01 00:00:00
abstract::The pathogenesis of HCC is poorly understood at present. There is insufficient understanding to propose a robust general model of hepatic carcinogenesis, partly because pathogenic host and environmental factors show significant regional variation, making such generalization difficult. Figure 4 is a model based on data...
journal_title:Clinics in liver disease
pub_type: 杂志文章,评审
doi:10.1016/s1089-3261(05)70154-9
更新日期:2001-02-01 00:00:00
abstract::Mathematical modeling of hepatitis C viral kinetics has been an important tool in understanding hepatitis C virus (HCV) infection dynamics and in estimating crucial in vivo parameters characterizing the effectiveness of HCV therapy. Because of the introduction of direct-acting antiviral agents, there is a need to exte...
journal_title:Clinics in liver disease
pub_type: 杂志文章,评审
doi:10.1016/j.cld.2012.09.003
更新日期:2013-02-01 00:00:00
abstract::Transjugular intrahepatic portosystemic shunt (TIPS) is a well-established procedure used in the management of complications of portal hypertension. Although the most robust evidence supports the use of TIPS as salvage therapy in variceal hemorrhage, secondary prophylaxis of variceal bleeding, and treatment of refract...
journal_title:Clinics in liver disease
pub_type: 杂志文章,评审
doi:10.1016/j.cld.2019.07.004
更新日期:2019-11-01 00:00:00
abstract::This article discusses direct-acting antiviral agents that target hepatitis C virus replication, their mechanism of action, strengths, and weaknesses. In addition, varying strategies using combinations of these agents are discussed. ...
journal_title:Clinics in liver disease
pub_type: 杂志文章,评审
doi:10.1016/j.cld.2015.06.002
更新日期:2015-11-01 00:00:00
abstract::In the intersection of alcohol ingestion with the law, medical ethics, and public safety, physicians are often unsure about how to proceed. Physicians' primary focus should be on patient education with an ethical and legal duty to warn the patient of the adverse effects of alcohol. Warning third parties of potential h...
journal_title:Clinics in liver disease
pub_type: 杂志文章,评审
doi:10.1016/j.cld.2018.09.002
更新日期:2019-02-01 00:00:00
abstract::The diagnosis of hepatic encephalopathy is predominantly clinical, and the tests available assist in the diagnosis only by excluding other causes. Covert hepatic encephalopathy, which is defined as abnormal performance on psychometric tests when standard neurologic examination is completely normal, has gained widespre...
journal_title:Clinics in liver disease
pub_type: 杂志文章,评审
doi:10.1016/j.cld.2015.04.001
更新日期:2015-08-01 00:00:00
abstract::The diagnosis of AIH depends on the finding of several suggestive features together with careful exclusion of liver diseases of other etiologies. Wherever possible, the diagnosis should be confirmed histologically by an experienced hepatopathologist. Seronegativity for the conventional autoantibodies at presentation d...
journal_title:Clinics in liver disease
pub_type: 杂志文章,评审
doi:10.1016/s1089-3261(02)00019-3
更新日期:2002-08-01 00:00:00